Understanding PBC: Symptoms, Fatigue, and What To Expect

Diet for PBC: 5 Foods To Eat and 5 Foods To Avoid

Medically reviewed by Johna Burdeos, RD

Written by Anastasia Climan, RDN, CDN

Updated on October 27, 2026

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Key Takeaways

Living with primary biliary cholangitis (PBC) can bring new challenges around eating, and while there is no single official diet for the condition, choosing nutritious foods can help support overall health.
Some foods that may be worth adding to a PBC-friendly diet include fatty fish, walnuts, kefir, oatmeal, and cooked spinach, as these can support heart health, bone health, and general nutrition. On the other hand, things like processed meats, sugary drinks, alcohol, and raw or undercooked proteins may be worth limiting or avoiding depending on your individual health needs.
Because nutrition needs can change as PBC progresses, talking with your healthcare provider or a registered dietitian nutritionist is a great step toward building an eating plan that works best for you.

View all takeaways

Living with primary biliary cholangitis (PBC) may mean you face challenges during activities that were previously simple, like deciding what to eat. Some people find they need to change their diet to manage their PBC symptoms.

There’s no official, one-size-fits-all diet for PBC, but nutritious foods can support your overall health. Your needs may change as symptoms arise or the disease progresses. The American Association for the Study of Liver Diseases notes that people with PBC may need monitoring and treatment for fat-soluble vitamin deficiencies.

Read on to discover which foods and beverages you may want to add to your diet and which you might consider limiting or avoiding.

5 Foods To Consider in a Diet for PBC

Fortunately, you can eat plenty of tasty foods to give your body the nutrition it needs with PBC. These options aren’t proven to treat PBC, but they can fit into a balanced eating pattern.

You may want to meet with a registered dietitian nutritionist for individualized recommendations. In the meantime, here are five nutritious options to consider adding to your diet.

Fatty Fish

Fatty fish like salmon and sardines provide unsaturated omega-3 fats. These fats can be part of a balanced diet for many people with PBC.

Include a couple of servings of fatty fish in your weekly menu if it fits your health needs, budget, and food preferences. If you’re concerned about the cost of seafood, look for sales on canned items with no added salt.

Mix canned salmon or sardines with low-fat mayonnaise or mashed avocado to make a sandwich filling similar to tuna salad. Fish cakes are another quick option with eggs, whole-grain bread crumbs, and salt-free seasonings.

Raw Walnuts

If you’re following a plant-based diet or just don’t like seafood, you can still get unsaturated fats from nuts and seeds. Try a small handful of raw walnuts, chia seeds, or ground flaxseed.

Add raw nuts and seeds to salads, yogurt parfaits, oatmeal, or homemade trail mix for a nutritional boost and satisfying crunch. These ingredients can also work well in simple PBC recipes, such as a fruit and yogurt bowl with chopped walnuts.

Kefir

Kefir is a fermented milk drink that can provide protein, calcium, and live cultures. The American Liver Foundation notes that low-fat kefir or yogurt may be a lower-sodium fermented food option for many people with PBC.

Probiotic benefits can vary, and kefir isn’t a specific treatment for PBC. Look for low-fat, low-sugar varieties in the refrigerated section, and ask your healthcare provider whether fermented foods fit your health needs.

Oatmeal

High cholesterol is common in people with PBC. Oatmeal is a whole-grain choice that provides soluble fiber, which can help lower LDL cholesterol as part of a heart-healthy eating pattern.

Enjoy your oatmeal with fruit, nuts, cinnamon, or chia seeds for added taste and texture. Choose plain oats when possible so you can control how much sugar and salt you add.

Cooked Spinach

Cooked spinach is a nutrient-dense way to add vegetables to meals. Dark leafy greens contain calcium and other nutrients that can support bone health.

It’s easy to add spinach to soups, pasta, casseroles, omelets, and smoothies. Buy spinach frozen or fresh, and include it as part of a balanced diet.

Spinach shouldn’t replace supplements or medications your healthcare team recommends. Guidance by the American Association for the Study of Liver Diseases (AASLD) says people with PBC should get calcium and vitamin D through diet and supplements if needed.

5 Foods and Drinks To Limit or Avoid With PBC

People with PBC can continue to enjoy a variety of foods and beverages. There’s usually no need for a highly restrictive diet, but some items may be worth limiting or avoiding depending on your individual health needs and complications, such as fluid retention, high cholesterol, or cirrhosis.

Your healthcare provider or dietitian can help you decide which changes are appropriate for you.

Processed Meats

Processed meats like bacon, sausage, hot dogs, and deli meats can be high in sodium and saturated fat. If you have edema or ascites, limiting sodium is especially important because sodium can cause your body to retain fluid, making swelling and fluid buildup worse.

Cooking fresh or frozen lean meats, poultry, fish, beans, lentils, or tofu may be a better fit for your health. If you’re comparing packaged foods, check the nutrition label for sodium and saturated fat.

If you use broth in soups or PBC recipes, choose low-sodium options when you can. The same idea applies to bone broth, which some people with PBC ask about.

Full-Fat Dairy Products

Dairy products can be a source of protein and calcium, which matter for bone health. People with PBC should get calcium and vitamin D in their diet and as supplements if needed.

However, full-fat dairy can also be high in saturated fat. Choosing low-fat or fat-free milk, cottage cheese, yogurt, or frozen desserts may help you get calcium with less saturated fat.

Keep in mind that some lower-fat products contain added sugar to make up for the taste difference. Compare labels, and consider adding fresh or frozen fruit to plain yogurt for flavor.

Sugary Drinks

Sugar-sweetened drinks can add a lot of simple sugar without making you feel full. For people with fatty liver disease, the National Institute of Diabetes and Digestive and Kidney Diseases recommends limiting foods and drinks high in simple sugars, especially fructose.

This doesn’t mean soda or sweet tea automatically causes fatty liver in everyone with PBC. Still, cutting back on sugary drinks can support overall liver and metabolic health.

Try naturally flavored seltzer, unsweetened tea, or a juice spritzer made with a splash of fruit juice and plain club soda. If you sweeten your coffee or tea, try reducing your usual amount a little at a time.

Raw or Undercooked Seafood, Meat, and Unpasteurized Dairy

Raw or undercooked seafood and meats and unpasteurized dairy products can carry harmful bacteria. Mayo Clinic says for people with liver disease, bacterial infections can be dangerous.

Avoid this risk by choosing fully cooked seafood and meats, and choose pasteurized dairy products. If you’re a fan of sushi, consider vegetarian rolls or rolls made with cooked seafood, like shrimp.

Alcohol

Alcohol can add stress to the liver and cause further damage. Most doctors recommend that people with PBC shouldn’t drink alcohol.

If you’re considering any alcohol use, talk with your healthcare professional first. They can assess your liver condition and explain what’s safest for you.

Foods To Avoid With Liver Cirrhosis and PBC

If your PBC progresses to cirrhosis, nutrition advice may become more individualized. If liver disease has caused significant scarring, your healthcare provider may recommend cutting back on sodium to help reduce fluid buildup and swelling.

People with cirrhosis usually need enough protein to prevent muscle loss. Ask your liver specialist or dietitian how much protein is right for you, what liver cirrhosis foods to avoid, and which foods to emphasize for your specific case and stage of PBC.

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